The invention relates to a transurethral dissection electrode with a shank and with an electrode head located at the distal shank end.
With adenomas of the prostrate occurring relatively often, particularly with elder men, because the free lumen of the urethra is continuously reduced by the growth of the adenoma, it is necessary for this ademona to be removed in order to prevent a complete closure of the urethra. The adenoma is not formed annular but is composed of several individual growths of differing sizes.
The removal of these individual growths until the present day has been effected in that by way of resectoscope loops the adenoma tissue is removed in a strip-like manner under endoscopic control. This type of removal of the adenoma tissue is relatively time-consuming and disadvantageous since for example a blood vessel in the adenoma tissue on removal is severed several times. By way of this continuous new quantities of blood get into the rinsing fluid located in the bladder and limit the view of the operator by way of the endoscope optic to a great extent. Since the contaminated rinsing fluid must be continuously led away and fresh rinsing fluid must be supplied, the duration of the endoscopic operation is lengthened which leads to unnecessary burdening of the patient and the operating personnel.
For a few years one has attempted to replace this so-called HF-resection of the prostate by laser, wherein the adenoma tissue proceeding from the sphincter, close to the ademona capsule, is practically peeled out in the direction of the neck of the bladder. This manner of proceeding is very tedious and also has the significant disadvantage that for this as a rule a relatively expensive laser must be provided, for which also there arise corresponding maintenance costs.
Proceeding from the known state of the art it is the object of the invention to provide a generic transurethral dissection electrode with which the prostrate adenoma without laser resection may be simply and effectively released from the inner wall of the urethra, close to the adenoma capsule, in order to be able to reduce the endoscopic operation burdening the patient to a great extent.
According to an essential aspect of the invention the dissection electrode according to the invention is wherein the electrode head essentially consists of at least one truncated cone body tapering distally with two oppositely lying flattenings.
With one embodiment example the electrode head distally ends in a circular surface. The head proximally in relation to the electrode longitudinal axis has larger radial dimensions than the cylindrical shank and here is designed atraumatically by way of rounding. By way of the design of the transurethral dissection electrode with the two flattenings lying opposite one another the safety on removal with a simultaneously good vaporization of the tissue as with a laser resection is increased. Furthermore this dissection electrode permits a good view of the field of operation.
With the transurethral dissection electrode according to the invention the adenoma is now no longer removed in layers but released from the so-called prostrate capsule. After an effected separation from the urethra inner wall the individual adenoma growths as a whole or after an effected severing may be easily removed from the urethra in the longitudinal direction.
The detachment of the adenoma is effected in that the electrode head is introduced between the urethra walling and the relatively rigid tissue surrounding the adenoma, thus the prostrate capsule. With this the tissue vaporizes in the region of the electrode head which is pivoted to and fro laterally along the capsule as well as is led in the direction of the bladder. By way of vaporization of the tissue in the region of the electrode the thus created gap is at least partly visible. By way of the low space requirement of the electrode, relatively little tissue is to be vaporized so that the electrode need only be operated with low electric energy.
With one embodiment example the electrode head essentially consists of two truncated cone bodies which form a unit, lie on the electrode longitudinal axis and in each case taper distally, and the flattenings extend proceeding from the first truncated cone body bodering the shank up to the second truncated cone body, wherein the first truncated cone body has a smaller acute angle than the second truncated cone body.
In an alternative embodiment form the flattenings may be formed in a manner such that they run distally inclined to one another with the same angle to the electrode longitudinal axis.